Rights, Access, and Entitlement to Healthcare

The founding principle of the NHS was of a universal service, with treatment to be provided on the basis of need. But that principle can be undermined by socioeconomic factors and social attitudes, such as misconception, stigma or hostility about or towards certain groups, which creates inequality of opportunity to access available health services. Furthermore, with increasing pressure on the funding of healthcare, people can have their access to services restricted by funding decisions that undermine the principle of universal provision.

Changes in the law, regulatory and funding environment can not only conflict with patients’ rights but also create dilemmas of conscience for healthcare professionals.

In such circumstances, how can healthcare professionals act ethically: as advocates for their patients and guardians of patients’ rights, and provide treatment based on need to all who need it? These are the issues the conference will explore though plenary sessions and workshops, with speakers from a wide range of academic and clinical backgrounds.

The conference will be of interest to anyone involved in teaching medical or other healthcare students, whether academics or clinicians. The focus will be on raising awareness of the difficulties faced by certain sections of the community or patient populations, but also on providing resources and ideas for effective teaching about the issues to both clinical and pre-clinical students.

Students, and newly qualified doctors and healthcare professionals, who are interested in the issues addressed by the conference, and who want to explore the issues further, are welcome.

10.00-10.30 Deprivation of Liberty Safeguards (Neil Allen, Barrister and Senior Lecturer at the University of Manchester, School of Law). Summary and explanation of the proposed changes to Deprivation of Liberty Safeguards.

10.30-11.15 Urban Village (UVMP are an Outstanding GP Practice commissioned to provide healthcare the homeless population in Manchester. Urban Village will explain their work to support and empower homeless people to overcome the barriers and stigma they face in accessing health services to which they are entitled, and the ethical challenges encountered by doctors engaged in this work.

11.15-11.45 Coffee break

11.45-12.30 Doctors of the World (medical charity that provides healthcare to excluded people across the UK). Doctors of the World will explain their work providing healthcare to excluded people, including migrants, refugees, trafficked people and sex workers, who can face legal as well as practical barriers in accessing health services, and their ethical commitment to equality of access to healthcare based on need, which can bring them into conflict with government rules and guidelines about provision of services.

12.30-1.30 Lunch (and judging of poster for Mark Brennan prize)

1.30-2.45 Workshops* (each delegate attends one)

2.45-3.00 Break

3.00-4.00 Plenary workshop: Effective use of resources

4.00-4.30 Closing statement by Dr Wing May Kong (Chair of the IME)

4.30-6.00 Drinks and networking reception

*Delegates will be asked to select a workshop when registering for the conference

Workshop topics

Mental health and stigma – The Wounded Healer

Dr Ahmed Hankir, Specialist trainee in Psychiatry, West Yorks, has a long term project on ‘The wounded healer’ which combines his experience as a psychiatrist and a person with bipolar disorder. The workshop will explore stigma around mental illness, including the stigma that exists within the medical profession in relation to students or doctors with mental health conditions, empirical research on stigma, and practical suggestions about how to overcome the barriers that exist to accessing mental health services.

Project PERFECTÂÂÂÂÂÂÂÂÂ is a multi-disciplinary team of researchers which “aims to create a more humane and realistic perception of mental distress, focusing on a person’s circumstances, strengths, and weaknesses, rather than diagnostic labels alone”. Its research is “showing that the so-called ‘marks of madness’ are not different in kind from everyday irrational thought. There is no sharp divide between the mentally distressed and the mentally well.” In the workshop Dr Stammers will explain the project’s findings and how they can help to challenge the stigma associated with mental illness. Clinical and non-clinical cases will be used as the basis of group discussion to explore the issues.

Patient experiences

Helen Salisbury andÂÂÂÂÂÂÂÂÂ Lisa HintonÂÂÂÂÂÂÂÂÂ of the Health Experiences Research Group (Oxford). HERG has developed a video and audio bank of patient experiences through which patients’ perspectives on and difficulties in accessing healthcare can be explored. The workshop will look at how this resource can aid the teaching of medical ethics, break down stigma and misconception, and improve understanding of the patient’s perspective.

Non-adherence

Dr David Warriner, Cardiologist, Leeds Teaching Hospitals Trust.

The workshop will explore the potential ethical conflict between respecting the patient’s right to self-discharge against medical advice and the doctor’s duty of care. Patients who self-discharge “are often disenfranchised and from hard to reach minority groups, and so this may represent a missed opportunity” to engage with patients and enhance their opportunity to access healthcare (BMJÂÂÂÂÂÂÂÂÂÂÂÂÂÂÂÂÂ 2011;343:d5054). The workshop will address what doctors can usefully and ethically do in such circumstances.

Challenging commissioning decisions

Dr Andrew Papanikitas (GO abd BIHR Academic Clinical Lecturer in General Practice, Oxford) and Dr Imran Sajid (London GP and Clinical Commissioner) who will explore the ethics of commissioning healthcare and when decisions about when healthcare funding should be challenged.

With some CCGs deciding to ration treatments to smokers and the obese, others rationing treatment until a condition is severe, or refusing to fund it all, the workshop will explore how doctors can challenge these decisions, advocate for patients and equitable access to healthcare, uphold the duty of care and yet responsibly manage resources.

Patients’ rights, confidentiality and the criminal law

Ruth Bromley (Lead for Ethics & Law, Manchester Medical School) and Andy Sidebotham (Superintendent, Greater Manchester Police).The workshop will explore issues relating to the duty of confidentiality and the patient’s right to privacy, and possible tensions with legal requirements to disclose information for the purposes of safeguarding, or to protect others from harmful or criminal behaviour. How can doctors reconcile their ethical and legal duties?

Call for Abstracts - IME 2018 Summer (Research) Conference

The Institute of Medical Ethics invites abstracts for its forthcoming conference in Oxford 19th and 20th June 2018. The conference is a two-day event, designed to give opportunities for academics, clinicians and students involved in biomedical ethics research and the medical humanities to present their current work.

The conference organisers welcome submissions from a range of disciplines relevant to bioethics, including medical ethics, medicine, healthcare, philosophy, social sciences, law, public policy and the medical humanities. In addition to submissions from established academics, early career researchers and healthcare professionals, we also encourage submissions from postgraduates and students who are intercalating in medical ethics or the medical humanities.

Formal contributions to the 2018 conference can take the form of posters, oral presentations or panel proposals. Single papers will have 25 minutes, to include questions. Panels will run for 75 minutes and should consist of two or three papers with sufficient time for audience discussion.

IME Student Conference

Evolving Ethics: Ethical Dilemmas of our Times

Saturday 10 February 2018

University of Sheffield

This is the first national conference organised by the IME Student Council. The day is aimed at all students & foundation doctors with an interest in medical ethics, and with variety of workshops ranging encompassing clinical ethics, global health issues and ethical dilemmas in research, there will be something for everyone! We will also be showcasing your work in medical ethics through oral and poster presentations.

Keynote SpeakerMr Robert Wheeler is a Consultant Paediatric and Neonatal surgeon specialising in oncology surgery. He is also director of the Department of Clinical Law at University Hospital Southampton NHS Foundation Trust, the first such department in the NHS. He provides clinicians with advice on how to deal with legal matters such as patient consent and confidentiality. His research interests include consent in children and the application of the doctrine res ipsa loquitur to surgical litigation.